The Canyon Creek Memory Care Community in Billings, where 43 of 55 residents and 15 staff members recently tested positive for COVID-19. Credit: Photo courtesy of Billings Gazette

The same day health officials announced a coronavirus outbreak at a Billings assisted living facility, Gov. Steve Bullock said Tuesday that his public health department will order all assisted living and nursing home facilities in the state to test all employees and residents before allowing any more visitors. 

The emergency order will give the state “stronger enforcement” authority to ensure such facilities are conducting adequate testing — which Bullock faulted the Billings facility for declining to do — to allow visitation and prevent outbreaks among their vulnerable populations. The order is expected to be issued by the Department of Public Health and Human Services on Wednesday, and will require facilities to test all staff and residents once, and then regularly conduct surveillance testing of employees.

“It’s clear that more needs to be done to protect residents not just in our nursing homes, but also in assisted living facilities,” Bullock said at a Tuesday press conference. “[By] guaranteeing the testing is being conducted on a regular basis, we can ensure that any evidence of the virus in a facility is caught early on and mitigated before it spreads further.”

Bullock’s announcement came hours after Yellowstone County health officials and management at the Canyon Creek Memory Care Community in Billings announced that a COVID-19 outbreak had infected 43 residents and 15 staff members at the facility. The new cases were among 80 new cases statewide confirmed by officials on Tuesday, the highest daily increase in confirmed cases since the virus emerged in Montana in March. 

The new cases brought Montana’s total number of infected to 1,327, with 716 recoveries. Twenty-two people are currently hospitalized, including two from the Canyon Creek cluster. 

Bullock said Tuesday that the state had previously encouraged all nursing home and assisted living facilities to voluntarily test all employees and residents, with the state paying for the testing. 

Of the 289 assisted living and long-term care facilities in Montana, 244 had participated in the voluntary testing and are preparing to conduct weekly testing. 

Canyon Creek was among several facilities in the state that has declined to participate in voluntary testing, Bullock said.

“If they want to continue to allow visitors for the residents, they will now be required to do that test,” he said. “The purpose of this rule is to help prevent what’s happened at Canyon Creek.”

Koelsch Communities, Canyon Creek’s parent company, didn’t immediately respond to a message on Tuesday afternoon asking why it declined to participate in the voluntary testing for staff and residents. 

In a press release issued earlier Tuesday, Koelsch Communities said family members have been notified of the outbreak. 

So far, 55 residents and 56 employees have been tested, with results pending for 24 tests. 

The facility said it has taken steps to separate infected residents from uninfected and is working to ensure that employees caring for infected residents don’t interact with those caring for uninfected residents. 

“Since the beginning of the COVID-19 outbreak, we have closely monitored and implemented all guidance from the Centers for Disease Control and Prevention and from state and local health departments to prevent transmission of the virus,” the Koelsch release said. “In Mid-February of this year, protocols were put in place at Canyon Creek to help prevent the exposure of COVID-19. These preventative procedures included: limiting visitation to only essential persons or in end of life situations, the screening of every individual upon entry to the community (including staff) for temperature, travel history, or known exposure and an increase in both food and PPE supply stock.”

In a separate release on Tuesday, Yellowstone County officials said they believed the outbreak was sparked by an employee or Canyon Creek visitor. 

While Bullock lifted the ban on most visitation at assisted living facilities late last month, Yellowstone County health officials instituted their own visitation ban on Friday after discovering cases in recent days at seven assisted living centers, including Canyon Creek. 

While most people who test positive for the virus will experience no or mild symptoms, it is especially dangerous for the elderly, county officials said, adding that about 80% of deaths attributed to COVID-19 in the U.S. have been among those who are at least 65 years old. 

“From the beginning of the COVID-19 pandemic, we have been concerned about an outbreak in a senior living facility,” said John Felton, Yellowstone County health officer and RiverStone Health president and CEO in a statement. “Seniors in congregate living situations are particularly vulnerable to tragic outcomes should they become infected with COVID-19. In this particular instance, we are especially concerned because of the challenges those with cognitive decline face in communicating, following personal hygiene instructions and their need for predictable routine.” 

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Chris Aadland covers tribal affairs in Montana as a Report for America corps member based in Billings. Before moving to Montana he covered the Wind River Reservation in Wyoming for the Casper Star-Tribune, and has also reported for the Wisconsin State Journal. Contact Chris at caadland@montanafreepress.org and follow @cjaadland on Twitter.